Suspected Physical Child Maltreatment

Childphysicalabuseis an important cause of pediatric morbidity and mortality and is associated with major physical and mental health problems that can extend into adulthood. Pediatricians are in a unique position to identify and preventchild abuse, and this clinical report provides guidance to the practitioner regarding indicators and evaluation of suspected physicalabuseof children.

This practice point will help clinicians to distinguish between accidental and inflicted bruises, to evaluate and manage bruising in the context of suspected child maltreatment, and to evaluate for an underlying medical predisposition to bruising.

This clinical report provides guidance to pediatricians and other clinicians regarding the evaluation for bleeding disorders whenchild abuseis suspected.

Initial imaging appropriateness criteria for suspected physical abuse in children.

Fractures are the second most common presentation of physical abuse after skin lesions, and approximately one third of abused children are eventually seen by an orthopaedic surgeon. Thus, an understanding of the differences in the general and musculoskeletal manifestations of accidental and nonaccidental injury is essential for recognition and appropriate management of the abused child.